Endocrine Abstracts

Use of SGLT2 inhibitors are increasing worldwide due to its potential antihyperglycemic role. Additionally they have shown to be beneficial in reducing the cardiac and renal complications in diabetes. There are sporadic reports to show their effects on liver enzymes. We did a single centre, open label, prospective trial to evaluate the role of dapagliflozin on hepatic enzymes in diabetic patients with non alcoholic fatty liver disease (NAFLD). Abdominal sonography was used to diagnose NAFLD. Individuals who were on hepatotoxic drugs or other drugs that could alter the liver enzymes or those who were alcoholics or had a history of liver disease were excluded. None of the participants were prescribed SGLT2i before. Subjects were randomly assigned to receive either dapagliflozin or placebo. Fasting blood sample was collected for HbA1c, AST & ALT measurement at study enrollment and then after 12 weeks of intervention. Antidiabetic therapy was continued and no other change in the treatment regimen was made during the study period. Paired t test was adopted for the statistical comparison between the groups. A total of 232 patients (M/F 137/95) were recruited for the study, with 131 persons (M/F 73/58) in the dapagliflozin arm and 101 subjects (M/F 64/37) in the placebo arm. Mean values for duration of diabetes (10.9±7.0 and 11.0±6.1 years), HbA1c (8.6±1.8% and 8.8±1.2%), AST (43.6±10.1 mg/dl and 41.1±15.1 mg/dl) and ALT (47.5±12.2 mg/dl and 42.5±16.5 mg/dl) were comparable in both the groups at baseline. Post treatment, in contrast to the placebo arm, HbA1c in the dapagifozin arm declined significantly to reach 7.73±1.4% (P <0.001). Similarly, the aminotransferases showed substantial improvement in the dapagliflozin arm (P <0.05), whereas there was no change in those values in placebo arm (P 0.61). Dapagliflozin also helped to reduce body weight of the individuals significantly during the course of the therapy. In addition to reducing HbA1c and weight, Dapagliflozin also significantly improves transaminitis in diabetic adults with non alcoholic fatty liver disease.